Family therapists’ adult attachment styles and the therapeutic alliance

Abstract

Therapists' adult attachment style may affect their ability to form effective therapeutic alliances. An analysis of semi-structured interviews with eleven family therapists explored the relationship between their adult attachment styles, as assessed using a self-report measure, and their perceptions of the therapeutic alliance. A framework analysis was employed, using four dimensions of the therapeutic alliance: engagement in the therapeutic process, emotional connection to the therapist, safety within the therapeutic system and shared sense of purpose within the family. Responses were compared between therapists with secure and insecure attachment styles according to different dimensions of the therapeutic alliance. There were no substantial differences in therapists' accounts of their approach to engagement and creating a sense of safety; however they differed in their approaches to managing clients' hostility. Secure and insecure therapists differed in one of the dimensions of therapeutic alliance; emotional connections to family members. Training and supervision could incorporate an understanding of attachment style. Suggestions are made for future research based on this exploratory study. Practitioner Points• The ability to co-create a secure base may be related to the therapist's adult attachment style. • Therapists with insecure attachment styles appear to have difficulty in managing clients' hostility and close emotional connections. • Trainees may benefit from understanding their own adult attachment styles and resolving outstanding family-of-origin issues. • Clinical supervision could reflect on the interaction between the therapist's and family attachment styles.

Predicting Therapeutic Alliance: Supervisory Alliance and Supervisee’s Attachment Style

“…However, the avoidant attachment style did not significantly contribute to the therapeutic alliance. Several studies, including Kandemir (2017), Sauer et al (2003), and Yusof and Carpenter (2016), have reported findings that are consistent with the those of the current study.…”

Young people, living in care and adopted, talk about their experiences of receiving an NHS therapeutic intervention. Qualitative research analysed using Interpretative Phenomenological Analysis

“…Prior to undertaking this study, my personal narrative was one of not being good enough (Lee & Littlejohns, 2007). A self-reflexive stance enabled me to reflect how my own attachment history encroached on my ability to connect with children and families in stressful sessions (Yusof & Carpenter, 2016). I noticed this in the interview with Charlie, as I felt uncomfortable when he was monosyllabic and my inner voice blamed myself (Rober, 2002(Rober, , 2008, believing I was not doing a good enough job to engage him.…”

“…I noticed this in the interview with Charlie, as I felt uncomfortable when he was monosyllabic and my inner voice blamed myself (Rober, 2002(Rober, , 2008, believing I was not doing a good enough job to engage him. Reflecting on this as I listened to his interview helped me understand how we both influenced one another (my preoccupied and his avoidant attachment styles), impacting on the therapeutic alliance (Dallos & Vetere, 2005Yusof & Carpenter, 2016). Rober (2008) reminds me to be aware of my feelings of comfort and discomfort in the session and to understand what this might mean, as this may create an opportunity to open up something new to explore.…”

Supporting and enhancing attachment resilience is essential for helping high‐risk families: But is the family keyworker the best one for the job?

“…For professionals who are not clinically trained in working with attachment repair, the risk of further damage is great and could result in avoidable trauma leading to additional negative outcomes. In addition, training programs for therapists or licensed clinicians require professionals to address personal issues that could interfere with a therapist's effectiveness (Suess et al, 2015; Yusof & Carpenter, 2016). Professionals untrained to use clinical interventions may not attend to these matters, and further, they are not subject to the same gatekeeping guidelines that are built into clinical training programs to keep individuals who are unsuitable for becoming therapists out of the field (Brear et al, 2008).…”